Application value of halo‑pelvic traction in the treatment of severe rigid spinal deformity.

IF 1.8 Q3 CLINICAL NEUROLOGY
Changlin Lv, Ziang Zhang, Xuanyu Dong, Jianyi Li, Jianwei Guo, Tianyu Bai, Xiaofan Du, Guodong Zhang, Jiale Shao, Jiayan Li, Yukun Du, Jun Dong, Guodong Wang, Yongming Xi
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引用次数: 0

Abstract

Purpose: Comparison of the clinical outcomes of halo-gravity traction (HGT) and halo-pelvic traction (HPT) was performed in the treatment of patients with severe rigid spinal deformity, with the aim of elucidating the clinical value of HGT and HPT in managing such deformities and providing evidence-based recommendations for surgical treatment planning.

Methods: A retrospective study was conducted of 20 patients treated at two large tertiary hospitals (2019-2022). All underwent posterior osteotomy correction and were categorized into HGT (n = 14) and HPT (n = 6) groups. Key parameters analyzed included radiographic measures (Cobb angles), pulmonary function tests (before and after traction/surgery), and intraoperative metrics such as blood loss, surgery duration, and osteotomy grade. Health-related quality of life was evaluated using the SRS-22 questionnaire.

Results: Baseline characteristics were comparable between groups. Compared to the HPT group, the HGT group showed significantly lower correction rates in both coronal and sagittal Cobb angles (P < 0.01), longer surgical duration, greater intraoperative blood loss, and higher osteotomy grade (P < 0.05). Improvements in FVC% and FEV1% were significantly smaller in the HGT group (P < 0.001). While both groups showed postoperative gains in SRS-22r scores, the differences between them were not statistically significant. No neurological complications occurred in either group; one case of iliac pin breakage in the HPT group was managed successfully without impacting the surgical outcome.

Conclusion: Both HGT and HPT were feasible and safe in the preoperative management of patients with severe rigid spinal deformity. In this limited cohort, HPT was associated with greater angular correction, improved pulmonary function, and reduced intraoperative complexity compared to HGT. While these findings are encouraging, larger prospective studies are warranted to validate the long-term efficacy and safety of HPT and to better inform clinical decision-making in high-risk spinal deformity cases.

晕盆牵引在治疗重度刚性脊柱畸形中的应用价值。
目的:比较halo-gravity牵引(HGT)与halo-骨盆牵引(HPT)治疗重度刚性脊柱畸形的临床效果,旨在阐明HGT与HPT治疗该类畸形的临床价值,为手术治疗方案提供循证建议。方法:对2019-2022年在两家大型三级医院就诊的20例患者进行回顾性研究。所有患者均行后路截骨矫正,分为HGT组(n = 14)和HPT组(n = 6)。分析的关键参数包括x线测量(Cobb角)、肺功能测试(牵引/手术前后)和术中指标,如出血量、手术时间和截骨分级。使用SRS-22问卷评估健康相关生活质量。结果:两组间基线特征具有可比性。与HPT组相比,HGT组在冠状和矢状Cobb角的矫正率均显著降低(P)。结论:HGT和HPT在严重刚性脊柱畸形患者的术前管理中是可行和安全的。在这个有限的队列中,与HGT相比,HPT与更大的角度矫正、改善的肺功能和降低的术中复杂性相关。虽然这些发现令人鼓舞,但需要更大规模的前瞻性研究来验证HPT的长期疗效和安全性,并为高风险脊柱畸形病例的临床决策提供更好的信息。
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来源期刊
CiteScore
3.20
自引率
18.80%
发文量
167
期刊介绍: Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.
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